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Abstract Number: 1221

Serum Uric Acid As an Independent Risk Factor on Progression of Chronic Kidney Disease in Gout Patients with Uric Acid Lowering Agent

Young Hyup Lim1, Eun-Jung Park1, Seulkee Lee2, Hemin Jeong3, Hyungjin Kim4, Jinseok Kim1, Jaejoon Lee5, Hoon-Suk Cha3 and Eun-Mi Koh6, 1Internal Medicine, Department of Medicine, Jeju National University Hospital, Jeju University School of Medicine, Republic of Korea, Jeju, South Korea, 2Internal Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, Seoul, South Korea, 3Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, 4Internal Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, Seul, South Korea, 5Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, 6Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Gout and uric acid

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Session Information

Session Title: Metabolic and Crystal Arthropathies: Mechanisms of Disease

Session Type: Abstract Submissions (ACR)

Background/Purpose

Hyperuricemia is particularly common in patients with chronic kidney disease (CKD). Its role, however, as a risk factor for renal outcomes of CKD is debated. This aim of study was to evaluate long-term effect of serum uric acid (SUA) level on progression of CKD in gout patients with uric acid lowering treatment.

Methods

All patients who had a first visit for gout with CKD at Samsung Medical Center between 1995 and 2003, and follow-up until December 2012 or expired during follow-up period were included and retrospective analyzed. CKD was defined as an estimated glomerular filtration rate (GFR) of < 60 mL/min/1.73m2 via MDRD Study equation more than 3 months. All serum creatinine and matched SUA taken during follow-up period were analyzed by using Mixed effect model to determine the effect of SUA level on renal outcome.

Results

One-hundred eleven gout patients with CKD were observed. The mean age of the patients at diagnosis of gout was 51.3 and mean follow-up duration was 13 years. Baseline eGFR and serum creatinine were 47.7 mL/min/1.73m2 and 1.62 mg/dL, respectively. Maintaining the SUA below 6 mg/dL showed protective effect on serum creatinine and eGFR compared with SUA more than 6 mg/dL (p < 0.0001 and p = 0.02, respectively). Mixed effect model demonstrated that the protective effect on renal outcome with maintaining the SUA below 6 mg/dL was statistically significant after adjusting baseline age, follow-up time, hypertension, diabetes mellitus, history of cardiovascular disease, obesity, and intrinsic renal disease (p < 0.0001). Hypertension, diabetes mellitus and follow-up time were independently associated with progression of chronic kidney disease (p < 0.001, p < 0.001 and p < 0.001, respectively). In particular, for every 1 mg/dL increase of the SUA, serum creatinine revealed to be increased 0.02 mg/dL when the SUA is more than 6 mg/dL (p < 0.0001). 

Conclusion

Our long term follow-up data demonstrated the SUA level was associated with progression of CKD in gout patients. Maintaining of SUA level below 6 mg/dL would be essential to protect renal function in gout patients with CKD.


Disclosure:

Y. H. Lim,
None;

E. J. Park,
None;

S. Lee,
None;

H. Jeong,
None;

H. Kim,
None;

J. Kim,
None;

J. Lee,
None;

H. S. Cha,
None;

E. M. Koh,
None.

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